In Utah, there are 10 Medigap plans that newly eligible beneficiaries may choose.
Additional Medigap plans are available for beneficiaries who became eligible before January 1, 2020.
Medigap plans do not cover prescription drugs.
The best time to enroll in Medigap is when you’re newly eligible.
If you’re newly dipping a toe into Medicare’s waters, you may be surprised to learn it doesn’t cover the full cost of medical bills. To fill in that gap and provide broader coverage, many Utahns opt into a Medicare Supplement Plan, also known as Medigap. As the nickname implies, Medigap policies fill in the “gap” left by Original Medicare (Part A and Part B).
Medigap plans cover some of what Medicare doesn’t pay. This includes out-of-pocket costs such as copays, coinsurance and the Part A monthly premium, should it apply to you. Unless you became eligible for Medicare before January 1, 2020, there is no Medigap plan you can buy that will cover the Part B monthly premium.
In Utah, there are 10 Medigap plans which may be available for you, as well as two high-deductible options. You can compare these plans in this side-by-side comparison chart.
Each of these plans is offered in Utah, but availability may vary between insurance companies and locations. There are also high-deductible versions of plans F and G, but plans C and F can no longer be sold to people who became eligible for Medicare after January 1, 2020. This is the result of a change that prohibits plans from fully covering Part B deductibles.
Medigap plans cover one person only. If you and your spouse both want Medigap, you’ll have to apply separately for your own plans.
Find a local Medicare plan that fits your needs
Even though coverage is uniform within plans, cost may not be. You may pay a higher premium for Plan A from one insurer than you will from another. In Utah, as in most other states, insurance companies are free to set their own costs for Medicare Supplement Plans.
In Utah, Medigap plans are available with a range of monthly premiums, copays, coinsurance and deductibles. Your gender and use of tobacco products may affect these costs. Smokers often pay higher premiums than nonsmokers for Medicare supplemental insurance. In some instances, women may pay less than men for the same plan.
For example, in Utah in 2022, Plan A monthly premiums range from $69 to $264 for a woman who doesn’t use tobacco products. A man of the same age who smokes will pay $82 to $293 for the same plans.
To be eligible for a Medicare Supplement Plan, you must already be enrolled in Medicare Part A and Part B. Age is not specifically a requirement for eligibility, but most plans are only available to Medicare beneficiaries who are 65 or older.
The best time to buy a Medicare Supplement Plan in Utah is when you first become eligible, during your initial six-month Medigap Open Enrollment Period. This period begins on the first day of the first month you have Medicare Part B.
During Medigap Open Enrollment, you can’t be turned down for a Medigap plan, even if you have a health condition such as cancer or diabetes. Medigap costs may also be lower during open enrollment than they will be if you enroll later.
Once open enrollment ends, you may have a harder time getting Medigap. State and federal laws don’t require insurance companies to sell this coverage to individuals with health conditions after their open enrollment period ends. If you have a health condition and can get Medigap, you may pay more for your plan.
Insurers can also refuse to sell plans to people under 65 years of age. If you qualify for Medicare due to a disability or illness, including end-stage renal disease (ESRD), you may not be able to get Medigap in Utah.
Once you have your plan, your insurer can’t drop you from it unless you don’t pay your premiums. Medigap standardized plans are guaranteed renewable. Your insurer can’t refuse to continue your coverage if you become ill.
To enroll in Medigap, compare the plans that are offered in your county. You can speak to a GoHealth licensed insurance agent to compare plans that are available where you live. You can also use Medicare’s find a plan tool.
Are you eligible for cost-saving Medicare subsidies?
Medigap policies sold after January 1, 2006, cannot include prescription drug coverage. If you would like to add prescription drug coverage to Original Medicare, you will need to enroll in a Part D plan.
Medigap plans only work with Original Medicare. You cannot enroll in a Medigap plan if you already have Medicare Advantage (Part C).
What’s important to remember is that Medicare Advantage provides a different type of coverage than Medicare Supplement Plans. Medigap covers out-of-pocket costs for services Medicare already pays for. The exception to this is foreign travel emergencies, which Medicare only covers in very specific circumstances.
Medicare Advantage plans are an alternative way to get everything Original Medicare provides. In addition, Part C plans may pay for some services not covered by Medicare, like:
- Prescription drugs
- Dental care
- Hearing aids
- Gym memberships (Silver Sneakers)
What extra benefits and savings do you qualify for?
Probably not. For people newly eligible for Medicare, Medigap plans no longer include coverage of the Part B premium. However, if you were eligible for Medicare before January 1, 2020, you may be able to get a Medigap plan that includes this coverage. If you already have a plan that covers the Part B premium, you are allowed to keep it.
That’s hard to say. The plan that’s best for you may not be the better choice for someone else. When deciding on the type of coverage you need, consider your current lifestyle and health needs, as well as what you anticipate in the future. Both Medigap and Medicare Part C may enrich your healthcare coverage, plus save you money. Talking it out with a licensed insurance agent may help you decide.
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